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Patient Forms

Please download and bring the completed New Patient Forms to your appointment so that you’re relaxed and not rushed when you arrive to our office. Please provide accurate and thoughtful responses to all questions so that we have a clear picture of your hearing health history when we meet with you.

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Adult Case History

 

 

 

 

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Pediatric Case History

Hearing Solutions of Louisiana – Sulphur

2100 Maplewood Drive
Sulphur, LA 70663
Tel: 337-528-7842
Fax: 337-439-2014

Hearing Solutions of Louisiana – Leesville

1017 Fertitta Boulevard
Leesville, LA 71446
Tel: 337-392-0026
Fax: 337-439-2014

Hearing Solutions of Louisiana – Lutcher

2454 Louisiana Avenue
Lutcher, LA 70071

Tel: 225-210-5158
Fax: 337-439-2014